Eto I, Bandy M D, Butterworth C E
Department of Nutrition Sciences, University of Alabama, Birmingham 35294.
J Autism Dev Disord. 1992 Jun;22(2):295-308. doi: 10.1007/BF01058157.
Tetrahydrobiopterin is essential for brain cells to make monoamine neurotransmitters. It has been reported that the concentrations of tetrahydrobiopterin in plasma and urine are low in certain mental disorders and that oral supplements are beneficial. A group of Japanese investigators have been conducting clinical trials of the effect of administration of tetrahydrobiopterin to autistic children and reported that it is beneficial with no significant side effects. We, therefore, initiated a study to assess plasma and urinary levels of tetrahydrobiopterin in infantile autism to see if they are reduced. Besides tetrahydrobiopterin, we also determined plasma and urinary levels of neopterin and monapterin in these individuals in order to evaluate the status of dihydroneopterin triphosphate, a key biosynthetic precursor of tetrahydrobiopterin. Sixteen autistic children and 12 healthy controls were included in this study. Results indicated that the plasma and urinary levels of tetrahydrobiopterin are not statistically different between the two groups and, therefore, no simple explanation for the beneficial effects of administration of tetrahydrobiopterin on autistic children can be offered at the present time. In contrast, plasma and urinary levels of neopterin were depressed (.01 less than p less than .05) and plasma monapterin was also significantly depressed (p less than .01) in autistic subjects compared with controls. Levels of other pterins, including folate, were not statistically different between the two groups. The basis for this depression in neopterin and monapterin is unknown. It does not seem likely that this depression could be attributed to a difference in age or T-lymphocyte/macrophage activity. However, further studies are needed to investigate these possibilities.
四氢生物蝶呤对于脑细胞合成单胺类神经递质至关重要。据报道，在某些精神障碍中，血浆和尿液中的四氢生物蝶呤浓度较低，口服补充剂有益。一组日本研究人员一直在对自闭症儿童服用四氢生物蝶呤的效果进行临床试验，并报告称其有益且无明显副作用。因此，我们开展了一项研究，以评估婴儿自闭症患者血浆和尿液中的四氢生物蝶呤水平，看其是否降低。除了四氢生物蝶呤，我们还测定了这些个体血浆和尿液中的新蝶呤和单蝶呤水平，以评估四氢生物蝶呤的关键生物合成前体三磷酸二氢新蝶呤的状态。本研究纳入了16名自闭症儿童和12名健康对照。结果表明，两组之间血浆和尿液中的四氢生物蝶呤水平无统计学差异，因此，目前无法对四氢生物蝶呤对自闭症儿童的有益作用给出简单解释。相比之下，与对照组相比，自闭症患者血浆和尿液中的新蝶呤水平降低（0.01 < p < 0.05），血浆单蝶呤水平也显著降低（p < 0.01）。两组之间包括叶酸在内的其他蝶呤水平无统计学差异。新蝶呤和单蝶呤水平降低的原因尚不清楚。这种降低似乎不太可能归因于年龄差异或T淋巴细胞/巨噬细胞活性差异。然而，需要进一步研究来探究这些可能性。
